USE OF COCAINE IN PREGNANCY

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(Date of issue: July 2011, Version: 1.2)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

A corresponding patient information leaflet on cocaine use in pregnancy is available at www.medicinesinpregnancy.org.

Summary

Cocaine is a tropane alkaloid with local anaesthetic and CNS stimulant properties.  Cocaine is legitimately (though rarely) used as a topical local anaesthetic and illicitly as a drug of abuse.  Cocaine is mainly abused by insufflation (snorting) but it can also be injected, smoked or ingested.  It causes acute vasoconstriction which may cause fetal haemorrhage and hypoxia.  Its use is contraindicated in pregnancy.

Data on cocaine use is heavily confounded, however cocaine use during pregnancy has been associated with increased risk of spontaneous abortion, placental abruption, premature labour, intrauterine growth retardation and Sudden Infant Death Syndrome (SIDS).  The teratogenicity of cocaine is not confirmed, however malformations observed in infants after prenatal cocaine exposure include microcephaly and malformations of the skeletal system, nervous system, gastrointestinal tract, genitourinary system and cardiovascular system.  Exposure in late pregnancy may lead to neonatal withdrawal in the infant.

Exposure to cocaine at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy but may warrant enhanced antenatal surveillance of fetal growth and development.

This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to be sure you are using the most up-to-date version.

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at www.toxbase.org.

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to ensure you are using the most up-to-date version.